|
PALMETTO FAMILY HEALTH CLINIC INC 401(K) P/S PLAN
|
2022
|
273254228
|
2023-06-28
|
PALMETTO FAMILY HEALTH CLINIC INC
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2019-01-01
|
| Business code |
621399
|
| Sponsor’s telephone number |
8504280361
|
| Plan sponsor’s
address |
4821 US HIGHWAY 98 W STE 104, SANTA ROSA BEACH, FL, 32459
|
Plan administrator’s name and address
| Administrator’s EIN |
273254228 |
| Plan administrator’s name |
PALMETTO FAMILY HEALTH CLINIC INC |
| Plan administrator’s
address |
4821 US HIGHWAY 98 W STE 104, SANTA ROSA BEACH, FL, 32459 |
| Administrator’s telephone number |
8504280361 |
Signature of
| Role |
Plan administrator |
| Date |
2023-06-28 |
| Name of individual signing |
KURT DONALDSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PALMETTO FAMILY HEALTH CLINIC INC 401(K) P/S PLAN
|
2021
|
273254228
|
2022-05-06
|
PALMETTO FAMILY HEALTH CLINIC INC
|
5
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2019-01-01
|
| Business code |
621399
|
| Sponsor’s telephone number |
8504280361
|
| Plan sponsor’s
address |
4821 US HIGHWAY 98 W STE 104, SANTA ROSA BEACH, FL, 32459
|
Plan administrator’s name and address
| Administrator’s EIN |
273254228 |
| Plan administrator’s name |
PALMETTO FAMILY HEALTH CLINIC INC |
| Plan administrator’s
address |
4821 US HIGHWAY 98 W STE 104, SANTA ROSA BEACH, FL, 32459 |
| Administrator’s telephone number |
8504280361 |
Signature of
| Role |
Plan administrator |
| Date |
2022-05-06 |
| Name of individual signing |
VICKY DANTZLER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PALMETTO FAMILY HEALTH CLINIC INC 401(K) P/S PLAN
|
2020
|
273254228
|
2021-05-12
|
PALMETTO FAMILY HEALTH CLINIC INC
|
4
|
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2019-01-01
|
| Business code |
621399
|
| Sponsor’s telephone number |
8504280361
|
| Plan sponsor’s
address |
4821 US HIGHWAY 98 W STE 104, SANTA ROSA BEACH, FL, 32459
|
Plan administrator’s name and address
| Administrator’s EIN |
273254228 |
| Plan administrator’s name |
PALMETTO FAMILY HEALTH CLINIC INC |
| Plan administrator’s
address |
4821 US HIGHWAY 98 W STE 104, SANTA ROSA BEACH, FL, 32459 |
| Administrator’s telephone number |
8504280361 |
Signature of
| Role |
Plan administrator |
| Date |
2021-05-12 |
| Name of individual signing |
YVETTE DONALDSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PALMETTO FAMILY HEALTH CLINIC INC 401(K) P/S PLAN
|
2020
|
273254228
|
2021-07-08
|
PALMETTO FAMILY HEALTH CLINIC INC
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2019-01-01
|
| Business code |
621399
|
| Sponsor’s telephone number |
8504280361
|
| Plan sponsor’s
address |
4821 US HIGHWAY 98 W STE 104, SANTA ROSA BEACH, FL, 32459
|
Plan administrator’s name and address
| Administrator’s EIN |
273254228 |
| Plan administrator’s name |
PALMETTO FAMILY HEALTH CLINIC INC |
| Plan administrator’s
address |
4821 US HIGHWAY 98 W STE 104, SANTA ROSA BEACH, FL, 32459 |
| Administrator’s telephone number |
8504280361 |
Signature of
| Role |
Plan administrator |
| Date |
2021-07-08 |
| Name of individual signing |
YVETTE DONALDSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PALMETTO FAMILY HEALTH CLINIC INC 401(K) P/S PLAN
|
2019
|
273254228
|
2020-06-08
|
PALMETTO FAMILY HEALTH CLINIC INC
|
6
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2019-01-01
|
| Business code |
621399
|
| Sponsor’s telephone number |
8504280361
|
| Plan sponsor’s
address |
4821 US HIGHWAY 98 W STE 104, SANTA ROSA BEACH, FL, 32459
|
Plan administrator’s name and address
| Administrator’s EIN |
273254228 |
| Plan administrator’s name |
PALMETTO FAMILY HEALTH CLINIC INC |
| Plan administrator’s
address |
4821 US HIGHWAY 98 W STE 104, SANTA ROSA BEACH, FL, 32459 |
| Administrator’s telephone number |
8504280361 |
Signature of
| Role |
Plan administrator |
| Date |
2020-06-08 |
| Name of individual signing |
YVETTE M. DONALDSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
